| Mydentist-ada | |
|
1430 Lonnie Abbott Blvd Ada OK 74820-1851 | |
| (580) 279-1716 | |
| Not Available |
| Full Name | Mydentist-ada |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1430 Lonnie Abbott Blvd, Ada, Oklahoma |
| Authorized Official Name and Position | Hannah Fish (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175405699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mydentist-ada 1430 Lonnie Abbott Blvd Ada OK 74820-1851 Ph: () - | Mydentist-ada 1430 Lonnie Abbott Blvd Ada OK 74820-1851 Ph: (580) 279-1716 |
| NPI Number | 1942620893 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942620893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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